The Variation Of Spine Bone Structure And The Clinical Significance For The Patients With Low Lumbar Intervertebral Disc Herniation

Objective:To measure and compare the construction parameters of lumbar spine bone structure in low lumbar disc herniation(LLDH) and to analyze dependability between changes of texture Parameters of lumbar vertebra and LLDH.the study was to investigate whether abnomalities of lumbar bony structure could lead to LLDH and to evaluate the importance of degeneration in degenerative lumbar disc.Materials and Methods:1 Date and case:2006 to 2008 hospitalizes in the orthopedics of the Affiliated Hospital of PuTian University with LLDH has 485 case,Screened 207 case of LLDH were randomly selected from them for the case group,143 cases of lumbar intervertebra disc unprotrusion were randomly selected from the patients with lumbar spine CT examinations in our hospital for the control group..2 Diagnostic criteria for lumbar disc herniation (according to Hu have proposed diagnostic criteria Valley):2.1 Leg suffers from the pain more then low spine which is the typical pain of the distribution area of sciatic nerve;2.2 The skin which the area distributed sciatic nerve feels numbness;2.3 Compared with the normal Lasegue-test reducing by 50%; and or the normal lasegue-test was positive,the radiating pain for whole leg caused by the Bowstring test;2.4 Nervous signs appeared in two of four signs (muscle atrophy, motor weakness, sensory loss and reflex decreased).3 Internalize standard:3.1 The patients meet the diagnostic criteria of the LLDH;3.2 Age range 25 to 65 years old;3.3 Lumbar disc herniation occurs at the L4/5 and L5/S1.4 Exclusion standard:4.1 Vertebral fracture, tumor, tuberculosis, infection,after surgery such as destruction of normal anatomy of posterior lumbar spine and other diseases;4.2 Cauda equina syndrome and patients with lower limb paralysi;4.3 Lumbar disc herniation did not occur at the L4/5 and L5/S1.5 Data Packet350 cases classified patient group and control group according to the information of pathogenetic condition;According to ages,divide it into 25 to 35 group;36 to 45 group;46 to55 6 Parameter measurement6.1 Spinous process deflection angle:the spinous process (centerline) and the sagittal plane of the deflection angle (see figure 1). At the same time tend to highlight the inter-disc recording spinous ipsilateral, contralateral or central prominence;6.2 Facet joint angle (transverse interfacet angel France):CT scan of parallel end-plates, taken all around edge of disc tangent center surrounded by a rectangular disc center. Take spinous process base center and center connection for lumbar intervertebral disc sagittal axis, Facet endpoint connections within and outside the sagittal axis angle and lumbar facet joint angle for the (d). Both sides of the facet joint morphology different and (or) both sides of the facet joint angle difference≥10°is defined as the facet joint asymmetry, while recording the non-symmetry of facet joints and the disc sub-type;6.3 Lumbar vertebrae curvature (Seze'S method):The forthcoming T12-S1 posterior margin of the formation of an arc-arc connection, measuring the distance from the top of the strings shall lumbar curvature;6.4 Angle of lumbar vertebrae curvature (Cobb, s law) that the T12 tangent to extend the line and the lower edge of the upper edge of S1 to extend the lines into the tangent of the angle;6.5 Lumbosacral angle (Gronkopff method):In the L5 lumbar vertebra on the lateral view the upper and lower edge of the central connection, and S1 vertebrae to connect the upper and lower edge of the central government into a corner of the intersection of the reference value range of 143°.Results1 Process deflection angle at L4, L5 levels had a significant statistical difference between the prominent group and the control. The date showed normal distribution.Using Rank sum test,it had a significant statistical difference (Z=-10.609,-12.074,P<0.01).2 The analysis show that there was not significant statistical difference(P=0.065 >0.05) compared the patient group and the control group on the facet asymmetry,Lumbar vertebrae curvature,Angle of lumbar vertebrae curvature and Lumbosacral angle.3 There only was significant difference on Lumbosacral angle between male group and female group (P=0.007<0.01);There was significant difference on the facet asymmetry,Lumbar vertebrae curvature,Angle of lumbar vertebrae curvature and Lumbosacral angle between 54-65 age group and 25-34 age group or 35-44 age group (P<0.01);There was significant differenceon the facet asymmetry,Lumbar vertebrae curvature,Angle of lumbar vertebrae curvature and Lumbosacral angle between 45-54 age group and 25-34 age group (P=0.0056<0.01).Conclusion:This group of studies have shown that the abnomalities of lumbar bony structure could not lead the lumbar disc herniation;But the abnomalities of lumbar bony structure aggravate the lumbar intervertebral disc degenerative.